Title: Yield of Video Assisted Thoracoscopy in Undiagnosed Pleural Effusions in South Indian Population
Authors: M. Umar Majid, A. K. Abdul Khader, C. P. Rouf
DOI: http://dx.doi.org/10.18535/jmscr/v3i8.22
DIDS : 08.2015-75285864
Pleural effusion of unknown etiology is a real diagnostic challenge for clinicians. Up to 75% of effusions are diagnosed with simple diagnostic thoracentesis but cause of a pleural effusion is not evident following diagnostic thoracentesis in up to 25 percent of patients. Medical thoracoscopy has received renewed interest in the recent past for diagnostic as well as therapeutic uses. In this study, we describe our experience with thoracoscopy for undiagnosed pleural effusions. Aims and objective: To study the yield of video assisted thoracoscopy in cases of pleural effusion where all the other diagnostic modalities failed to give a definite diagnosis. Materials and Methods: Analysis of thoracoscopic procedures performed for undiagnosed pleural effusion cases between March 2002 to Feb. 2010 at Chest Hospital. Yield of thoracoscopic pleural biopsy for achieving a diagnosis in undiagnosed pleural effusions, was evaluated. Complications of thoracoscopy were also analyzed. Results: A total of 84 patients met the study criteria and were included. Diagnostic yield of Zthoracoscopic pleural biopsy was 100%. Pleural malignancy was diagnosed in 73.8% of patients. There were only 4 cases of mesothelioma and the rest were of pleural metastasis. Lung cancer was the most common cause of primary malignancy. Adenocarcinoma being the most common type. Tuberculosis was diagnosed in 26.2% of patients. No major complications after thoracoscopy were observed. Most common minor complication observed was pain (35.7%). Conclusion: Video assisted thoracoscopy is a safe procedure and has excellent diagnostic yield in patients with undiagnosed pleural effusions. Keywords: Thoracoscopy, pleural effusion, tuberculosis, malignancy 1. Broaddus VC. Fluid and solute exchange in normal physiological states. 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